Xu Shuo, Chen Shaofan, Chen Ningling, Zhang Zhengcong, Liang Chenfang, Huang Hongwei, Zou Huijie, Jiang Haoqing
Department of Rehabilitation Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
Neural Plast. 2025 Jun 6;2025:1362222. doi: 10.1155/np/1362222. eCollection 2025.
Intermittent theta-burst stimulation (iTBS) targeting the cerebellum represents a promising therapeutic approach, demonstrating efficacy in the rehabilitation of motor and cognitive impairments after stroke. This study aims to evaluate the real-time and immediate effects of cerebellar iTBS on the cerebral cortex of stroke patients. This study was conducted in a crossover design, initiating with sham-iTBS followed by iTBS after a 24-h washout period. The functional near-infrared spectroscopy (fNIRS) was applied to observe cortical activation from cerebellar iTBS in stroke patients and changes in resting-state functional connectivity (FC) and amplitude of low-frequency fluctuations (ALFF) poststimulation. Compared to sham stimulation, significant enhancement of cortical activation was observed in the left dorsolateral prefrontal cortex (DLPFC; Channel 26, = 2.47, =0.036, Cohen's = 0.783) and left primary motor cortex (PMC; Channel 61, = 2.88, =0.018, Cohen's = 0.907; Channel 62, = 2.62, =0.028, Cohen's = 0.826). Compared to the resting period after sham-iTBS, the resting period following iTBS demonstrated significantly enhanced FC between the temporal cortex (TC) and the somatosensory cortex (SSC) (=0.029), as well as between the frontal eye field (FEF) and the PMC (=0.031). Additionally, the ALFF value of the medial superior frontal gyrus (SFGmed) also increased significantly during the resting period after iTBS (Channel 20, = 5.79, =0.027, Cohen's = 0.63). The application of iTBS to the cerebellum significantly enhances the activation of cognitive and motor areas in the cerebral cortex. Additionally, improved FC between brain regions and increased spontaneous neuronal activity were observed following stimulation. These findings reveal the potential mechanisms by which cerebellar iTBS may facilitate functional recovery in stroke patients.
针对小脑的间歇性θ波爆发刺激（iTBS）是一种很有前景的治疗方法，已证明其在中风后运动和认知障碍康复中具有疗效。本研究旨在评估小脑iTBS对中风患者大脑皮层的实时和即时影响。本研究采用交叉设计，先进行假iTBS，经过24小时洗脱期后再进行iTBS。应用功能近红外光谱（fNIRS）观察中风患者小脑iTBS引起的皮层激活以及刺激后静息态功能连接（FC）和低频波动幅度（ALFF）的变化。与假刺激相比，在左侧背外侧前额叶皮层（DLPFC；通道26， = 2.47， = 0.036，科恩氏 = 0.783）和左侧初级运动皮层（PMC；通道61， = 2.88， = 0.018，科恩氏 = 0.907；通道62， = 2.62， = 0.028，科恩氏 = 0.826）观察到皮层激活显著增强。与假iTBS后的静息期相比，iTBS后的静息期显示颞叶皮层（TC）与体感皮层（SSC）之间的FC显著增强（ = 0.029），以及额眼区（FEF）与PMC之间的FC显著增强（ = 0.031）。此外，在iTBS后的静息期，内侧额上回（SFGmed）的ALFF值也显著增加（通道20， = 5.79， = 0.027，科恩氏 = 0.63）。对小脑应用iTBS可显著增强大脑皮层认知和运动区域的激活。此外，刺激后观察到脑区之间的FC改善以及自发神经元活动增加。这些发现揭示了小脑iTBS可能促进中风患者功能恢复的潜在机制。
